AYUSH Keralam - Similima

AYUSH Keralam
Dr. R. Rejikumar BHMS, MD(Hom)
Consultant (AYUSH Integration),
State Health System Resource Centre
Kerala
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AYUSH
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SWOT Analysis - AYUSH
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• Safety
• Efficacy
• Cost factor
• Indigenous
• Traditional
• Complementary
• Global demands
Strengths
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• Statistical Data
• Research
• Budget allocation
• Quality of drug.
• Dispensing
• Trained manpower
• Diagnostic tools.
• Emergency
management
Weaknesses
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• Specific areas
– Rheumatic affections
– Anorectal disorders
– Mother & Child health
– Skin & Respiratory
allergic diseases
– Psychosomatic illness
– Infectious diseases
– Lifestyle diseases
Opportunities
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• Quacks /
inadequately qualified
persons.
• Lack of knowledge
updating.
Threats
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Strategy
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Ayurveda
� earliest concepts - Vedas, esp.Atharvaveda
(2nd millen. BC)
� Ayurveda : Brahma � Dhanvantari - deified
as the God of Medicine.
� Charaka Samhitha - 500 medicinal plants
� Susrutha Samhitha’ - 760 medicinal plants
� Vagabhatta (8th century) : Tridosha Theory :
Body balance - 3 elementary substances –
vatha, pitha & kapha.
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• a way of life,
Yoga
• an integrated means of synchronizing
mind, spirit, and body.
• originated in India, thousands of years ago
MORARJI DESAI NATIONAL INSTITUTE OF YOGA
(An autonomous organization under Deptt. of AYUSH, Ministry of Health & F. W.,
Govt. of India )
68, Ashok Road, Near Gole Dak Khana, New Delhi – 110 001
Ph : 011 - 23730417, 23730418, 23718301, 23721472. Fax – 23711657
E-Mail: mdniy@yahoo.co.in Website : www.yogamdniy.nic.in
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Naturopathy
• Naturopathy is an art and science of healthy living
• a drugless system of healing based on well founded
philosophy.
• morbid matter theory, concept of vital force and other
concepts upon which Naturopathy is based are already
available in old texts.
• The revival of Naturopathy started in India by translation
of Germany’s Louis Kuhne’s book “New Science of
Healing”.
• Shri D. Venkat Chelapati Sharma translated this book in
Telgu language in 1894.
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Unani
• "Unani" = "Ionian"
• strong Greek influence
• Oriental medicine / "Unani-Tibb"
• Avicenna (Hakim Abu Ali Abdullah Husayn Ibn Sina)
• ~ 4 - humour theory of Hippocrates
• 7 components of human body
i. Elements (Arkan)
ii. Temperament (Mizaj)
iii. Humors (Akhlat)
iv. Organs (Aaza)
v. Spirits (Arwah)
vi. Faculties (Quwa)
vii. Functions (Afaal)
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Siddha
• special focus on food habits consisting with six
tastes.
• Derangement of Uyir thathu leads to diseases of
body and mind.
• Causes of diseases as per Siddha system are
– Unavu (food)
– Seyal (doings)
– Kaalam (climate and environment)
– Kanmam (by birth)
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Homoeopathy
Dr. Samuel Hahnemann MD (1755-1843)
• Law of Similia- a sick person can be cured by a substance
that has the ability to produce similar symptoms, as those
of his disease.
• Law of Simplex- a single medicine is used for a patient at a time.
• Law of Minimum- minimum dose, sufficient to initiate the healing
process, is prescribed. Such dose produces no toxic effect in the body.
• Doctrine of Drug Proving- curative power of a drug substance is known
by administering it to healthy human beings.
• Theory of Vital Force- Homoeopathy believes in a regulating force (Vital
force) in human body.
• Doctrine of Drug-dynamisation- Homoeopathy medicines are prepared in
a special way known as Drug dynamisation or Potentisation, where drug
substance is diluted and succussed so as to reduce the material dose
while retaining its medicinal properties.
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• CCIM
• CCH
• CCRAS
• CCRUM
• CCRH
• NIA
• NIH
• MDNIY
AYUSH - India
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AYUSH - Kerala
• 2 Separate Directorates
– DISM & DH for ISM & Homeopathy
respectively
• 1300 ( 53 %) AYUSH institutions
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Ayurveda Factsheet
• Under Directorate of Indian Systems of Medicine
– Dispensaries = 736
– Hospitals = 115
– Total no. of In-Patient Beds = 2764
• Under Directorate of Ayurveda Medical Education
– Govt. Ayurveda Colleges = 3
– Aided Ayurveda Colleges = 2
– Self Financing Ayurveda Colleges = 10
– Total BAMS seats = 740
– Total MD(Ay) seats = 110
– Total Paramedical seats = 1441
• Under NRHM
– Dispensaries = 172
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Ayurveda
• Total temporary dispensaries : 172
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Homoeopathy Factsheet
• Under Directorate of Homoeopathy
– Dispensaries = 526
– Hospitals = 30
– Total no. of In-Patient Beds = 945
• Under Controlling Officer of Homoeopathic Medical Education
– Govt. Homoeopathic Medical Colleges = 2
– Aided Homoeopathic Medical Colleges = 3
– Total BHMS seats = 250
– Total MD(Hom) seats = 36
– Total Paramedical seats = 100
• Under NRHM
– Temporary Homoeo Dispensaries = 276
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Temporary Homoeo Dispensaries
Homoeopathy
= 276
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Yoga & Naturopathy
• Naturopathy Hospital at Varkala was
upgraded.
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Unani
• 1 dispensary under DISM
– Mogral, Uduma, Kasargode.
• 11 temporary dispensaries functional
under NRHM
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Siddha
• 3 Hospitals under DISM
– 1 independent hospital Vallakadavu,
Thiruvananthapuram
– 2 IP wings attached to GAH, Neyyattinkara &
DAH, Thodupuzha
• 6 dispensaries under DISM
• 12 Temporary dispensaries sanctioned
under NRHM will be established soon.
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List of sanctioned Siddha temporary dispensaries
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AYUSH
• Fact sheet prepared (situation analysis)
• Roadmap prepared (action plan)
• Capacity building in progress
• Infrastructure development in progress
• PMU established
• Research studies planned
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AYUSH Action Plan (Road Map)
• It was prepared and submitted to the
authorities in November 2009.
• The following innovations were proposed.
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Infrastructure development
• A. Construction / Renovation
• I. Construction works of Dispensaries /
Hospitals should be undertaken in
• those LSGIs with meager funds.
• B. Additional facilities
• I. Laboratary facilities, ECG, X-ray & USG
units should be started
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HR Planning
• A. Recruitment
• i. Posting of Medical Officers in temporary dispensaries.
• ii. New recruitment should be done in uncovered
Panchayaths.
• iii. Paramedical Staff & Attenders to be posted in all
dispensaries
• B. Transfer
• i. Requests, status & orders should be completely online.
• ii. As far as possible, staff should be posted in the
districts of their choice.
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HR Management
• A. Remuneration
• I. Remuneration of Medical Officers should be
enhanced.
• II. Post Graduate Degree allowance should be
given to Medical Officers with PG qualification.
• III. Special Allowance should be given to Medical
Officers working in difficult Rural areas &
inaccessible rural areas
• IV. Parity of remuneration should be maintained
among doctors of all systems working under
NRHM.
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HR Training
• I. Induction training to MOs on NRHM,
National flagship programs,Administration,
Accounts & Stock management.
• II. In-service training to MOs in
Computers, Open-source office
automation & soft skills.
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• A. Clinical
Research
• I. Prospective studies should be funded &
monitored
• B. Retrospective analysis
• I. Epidemic Prophylactic efficacy studies
should be done.
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PMU
• PMSU should be separately set up for
AYUSH systems
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Establishment of Dispensaries
• Total 459 temporary AYUSH
Dispensaries each with a Medical
Officer
– 276 Homoeo Medical officers
– 172 Ayurveda Medical Officers
– 11 Unani Medical Officers
12 Siddha Dispensaries are newly
sanctioned and will be started soon.
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Timeline - Homoeopathy
• 10.11.2008 : Sanction for 41 Homoeo Dispensaries
[G.O (Rt) 3710/2008/H&FWD]
• 26.02.2009 : Modified conditions
[G.O (Rt) 528/2009/H&FWD]
• 28.02.2009 : Sanction for 101 Homoeo Dispensaries
[G.O (Rt) 545/2009/H&FWD]
• 01.10.2009 : Sanction for 136 Homoeo Dispensaries
11-Jan-11
[G.O (Rt) 2825/2009/H&FWD]
Dr. R. Rejikumar www.similima.com MD(Hom), Consultant
35
(AYUSH Integration) 35

Timeline - Ayurveda
• 13.11.2008 : Sanction for 48 Ayurveda Dispensaries
[G.O (Rt) 3766/2008/H&FWD]
• 26.02.2009 : Modified conditions
[G.O (Rt) 527/2009/H&FWD]
• 28.02.2009 : Sanction for 52 Ayurveda Dispensaries
11-Jan-11
[G.O (Rt) 547/2009/H&FWD]
Dr. R. Rejikumar www.similima.com MD(Hom), Consultant
36
(AYUSH Integration) 36

MO & Medicines
– Medical Officer and Medicines are given
through NRHM while basic infrastructure,
paramedical staff and other logistics is to be
provided by the concerned Panchayats.
– Drugs for Homoeo is procured through
HOMCO, which is a company under the State
Government manufacturing Homoeo drugs
– Drugs for Ayurveda is procured from
Oushadhi which is a Govt. company.
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Paramedical staff
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Year
Opening
Balance
Fund received
Total fund
with the
Society
Expenditure
reported
2005-06 2.48 34.45 36.93 3.90 11
2006-07 33.03 80.60 113.63 17.64 16
2007-08 95.99 120.00 215.99 116.99 54
2008-09 99.00
2009-10 (as
on 31.01.10 at (HO)
and as on
31.12.09
from Dist)
103.0
7
FINANCIAL SUMMARY (Rs.in Crores)
232.47+
53.25*
151.42+29.
25*
%
384.72 281.65 73
283.74 225.73 80
Total 701.44 645.91 92
* State Share (TRP and Flagship Programme)
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PIP for AYUSH
Activity Exp. 09-10 Budget 10-
11
Mission Flexible Pool
Mainstreaming of AYUSH 223.98 970.20
Addl. Contract staff 543.74 0
Incentives 789.12 1085.34
Total 1556.84 2055.54
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PIP 2010 - 2011
Manpower
Remuneration
Rs 6,12,00,000/-
Medicines @
50,000 per
Dispensary :
Rs 7,50,000/-
Total Amount :
Rs 6,19,50,000/-
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Manpower
Remuneration :
Rs 7,05,74,400
Medicines @
25,000 per
Dispensary :
Rs 69,00,000
Total Amount :
Rs 7,74,74,400
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• Manpower Remuneration : Rs. 27,98,400/-
• Medicines @ 50,000 per Dispensary : Rs. 5,50,000/-
• Total Amount : Rs. 32,98,400/-
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Approved RoP for AYUSH
2010 -11
Activity Proposed
Budget
Mission Flexible Pool
Approved
Budget
Mainstreaming of AYUSH 900 lakhs 786 lakhs*
* 437 MOs X 15000 X 12 months = ` 7,86,00,000
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Hospital Upgradation
• Rs 28,11,92,000 have been sanctioned
from Dept. of AYUSH, GoI for the
upgradation of hospitals.
• It includes provision of necessary
manpower & equipments also.
• Lab facilities are provided in District
Hospitals with X-ray & Ultrasound Scan
units.
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AYUSH Hospital Upgradation
Phase - 1
Ayurveda Homoeopathy
� Thiruvananthapuram 2 2
� Kollam 2 2
� Pathanamthitta 2 0
� Alappuzha 3 1
� Kottayam 2 2
� Idukki 2 2
� Ernakulam 3 1
� Thrissur 4 0
� Palakkad 2 0
� Malappuram 1 1
� Kozhikode 3 1
� Wayanad 2 1
� Kannur 3 1
� Kasargode 3 1
Total 34 15
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AYUSH Hospital Upgradation
Phase - 2
Ayurveda Homoeopathy
� Thiruvananthapuram 4 2
� Kollam 3 1
� Pathanamthitta 1 0
� Alappuzha 3 2
� Kottayam 3 1
� Idukki 1 0
� Ernakulam 4 2
� Thrissur 3 1
� Palakkad 3 1
� Malappuram 2 1
� Kozhikode 2 2
� Wayanad 2 0
� Kannur 1 0
� Kasargode 1 2
Total 34 15
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Centre of Excellence
• Govt. Ayurveda Panchakarma Hospital,
Alappuzha is to be upgraded to a centre of
excellence.
• The project is approved by Dept. of
AYUSH, GoI.
• Rs 5 crore fund will be received
• Transfer of land in progress.
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Ayurveda Mission Document
• It is being prepared by FRLHT, Bangalore
based on the workshops organised by
PMU (AYUSH) in Kerala.
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Future Projects
• Upgradation of AYUSH Dispensaries
(10 Ayurveda & 5 Homoeo in each district)
• Induction & Inservice trainings
• HMIS incorporation of AYUSH institutions.
• NABH accreditation of AYUSH Hospitals.
• Prophylactic & Curative Research studies.
• Facility survey of AYUSH institutions.
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Focus areas
• Provision of basic infrastructure,
paramedical staff & medicines to
temporary dispensaries under NRHM.
• Collaborating AYUSH systems in
– Palliative Care
– Mental Health projects
– School Health projects
– NCD programme
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PMU (AYUSH)
• Dr. M. R. Vasudevan Namboothiri MD (Ay)
State Programme Manager (AYUSH)
Programme Management Unit (AYUSH), Kerala
Ph : 9946105700 E-mail : vnampoothiri@gmail.com
• Dr. R. Rejikumar BHMS, MD(Hom)
Consultant (AYUSH Integration),
State Health System Resource Centre, Kerala
Ph : 9946105470 E-mail : drrejikumar@gmail.com
• Mr. Ajit Prasad K. K
Administrative Officer (Addl. Charge), SHSRC
Consultant (Admn.), NRHM
Ph : 9946105700 E-mail : ajit.kki@bsnl.in
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SHSRC Kerala
Organogram
SMD
Secretary
(Healt ED
PHP AYUSH ARC
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State Health Systems Resource Centre
Objectives
• · To provide technical assistance and capacity building measures to
• Dist. health Institutions
• · Providing Support to State Health system to develop strategy
• planning in health initiations, innovation and change management
• · Quality improvement in health care through managerial
• interventions
• · To derive a viable Human Resource Planning (HRP) for all health
• institutions
• · To under take reform activities in Health institutions
• · To act as Health Data Warehouse
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Vision
• · Evaluation of current strategies of district level
health plans initiated by NRHM
• · Gap analysis in Health Service Delivery –
current status
• · HMIS –its status (effectiveness study)
• · HRP for all institutions for the year 2010-11
• · Evaluation of quality improvement systems
implemented in district level institutions
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Plans
• Programmes for integrating AYUSH activities to
improve Health Service Delivery to the public
• · Evaluation of ASHA activities for women and
child care in Kerala
• · Evaluation study on utility of infrastructure
development done under NRHM in Kerala
• · Submission of report to the Government from
the studies under taken as above.
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Public Health Planning
• DHAP Technical assistance
• PIP preparation
• Research Methodology workshops
• RSBY impact assessment
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AYUSH Integration
• Integration of Infrastructure, Manpower &
Medicines of Ayurveda, Yoga &
Naturopathy, Unani, Siddha and
Homoeopathy (AYUSH) Systems to
strengthen the Public Health Care delivery
and strengthen the AYUSH systems at
grass root level by establishing a linkage
with Modern Medicine i.e, Allopathy in a
collaborative way.
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ASHA Resource Centre
ASHA was sanctioned to the State only in 2007.
31000 out of 32000 were selected and deployed.
Training being undertaken
• Faciltation Cell & Data bank in progress
• ASHA Mentoring Group to be started
• Implementation of NCD program through
ASHA
• Training to ASHA on AYUSH (Module 5)
• Impact Assessment of ASHA
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www.arogyakeralam.gov.in
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http://www.arogyakeralam.gov.in
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www.indiamedicine.nic.in
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11-Jan-11
Dr. R. Rejikumar
99 46 10 54 70
0471-4062271 (Off)
0471-4062270 (Fax)
drrejikumar@gmail.com
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Dr. R. Rejikumar MD(Hom), Consultant
(AYUSH Integration) 64